Public Health Improvement - Preventive Health and Health Services Block Grant (PHHSBG)

The Preventive Health and Health Services Block Grant (PHHSBG), created in 1981, allocates funds to every state for their use toward any objective outlined in the nation’s public health blueprint titled Healthy People 2030. The grant allows the state to address some of the high priority public health issues as determined by mortality, morbidity, and economic cost data for the state. The program areas funded annually submit a plan that states the public health issue that will be addressed, provides a description of the strategy used to address the public health concern, identifies the target population and how the program addresses the targeted population needs, and identifies the national and state health status outcome objectives each program will work toward achieving as reflected in Healthy People 2030. Each program outlines activities that support one or more of the 10 essential public health services recognized by the Centers for Disease Control and Prevention. Maintaining support for this grant is critical in allowing Texas to focus funds on prevention measures that yield clear benefits in terms of quality of life and savings.

The PHHSBG was funded nationally at $168 million in fiscal year 2023. Texas’s share was $7.2 million, of which $608,448 was a mandatory set-aside for rape response and prevention services administered by the Office of the Attorney General (OAG).

DSHS uses PHHSBG funds to support the following six programs:

Local Health Entities

The goal of this program is to increase efficiency and effectiveness in health departments by providing a coordinated system of public health through local health entities (LHEs) and public health regions by ensuring the provision of essential public health services. LHEs use grant funds to provide for self-identified gaps in essential public health services. Using CDC’s definition of “essential public health services” as a framework, LHEs assess which critical areas of their infrastructure to apply these funds. In some cases, services outlined in LHE work plans would not exist in these communities if it were not for the provision of PHHSBG. The majority of services include: providing education and outreach to the community for disease prevention and other priority health concerns; monitoring and surveilling the community’s health status through disease reporting and investigation; mobilizing community resources to develop plans around health issues in their jurisdiction; reviewing local policies to ensure that standards are maintained in providing health services; and monitoring the public health workforce to ensure federal or state licensure and certification standards are met. LHEs funded through this grant are required to identify national, state, or local standards to be used to evaluate the activities provided. Based on quarterly reporting measures, LHEs are required to identify barriers to providing services and develop improvement plans that may include new or alternative strategies to effectively provide the services outlined in their work plans.

Community and Clinical Preventive Services – Tobacco Cessation

This program is under the direction of the DSHS Division of Community Health Improvement. The goal of this program is to implement and expand evidence-based strategies in community and health care settings to improve access to tobacco cessation resources to reduce the impact of tobacco use and related chronic disease. Through a subcontract with The University of Texas at Austin Tobacco Research and Evaluation Team, this program uses grant funds to enhance local health care systems to improve tobacco use screening, counseling, and referrals to the Texas Quitline. The project identifies and engages health care systems across Texas to integrate the eTobacco Protocol into their electronic health records. Integration of the eTobacco Protocol allows for easier access for providers to refer patients who use tobacco products to the Texas Quitline, which begins the process of tobacco cessation efforts. The team also provides trainings for health care providers on the use of the eTobacco Protocol, use of the Texas Quitline, and non-electronic referral methods to the Texas Quitline.

Community and Clinical Preventive Services – Preventive Healthcare

This program is under the direction of the DSHS Division of Community Health Improvement. The goal of this program is to implement and expand evidence-based strategies developed to reduce the impact of obesity and other chronic diseases in community and health care settings by focusing on clinical and community systems-level enhancements. Through subcontracts with five local public health entities, grant funds support coordinated, locally driven approaches to obesity and chronic disease management and prevention. Program strategies include creating new clinical-community linkages to strengthen referral systems; standardizing clinical quality measures through enhanced health information technology; and facilitating evidence-based education and training for providers, clients, and the public.

Community and Clinical Preventive Services – Information Technology

This program is under the direction of the DSHS Division of Community Health Improvement. The goal of this program is to implement and expand evidence-based strategies and priority activities developed to reduce the impact of obesity and other chronic diseases in Texas by focusing on clinical and community systems-level enhancements. Through subcontracts with up to five local public health organizations, grant funds support coordinated, locally driven approaches to obesity and chronic disease management and prevention. This program addresses access to preventive health services to impact obesity and related chronic disease by increasing clinical and community referrals to those services through the enhancement of health information technology.

Texas Healthy Communities

This program is under the direction of the DSHS Division of Community Health Improvement. The goals of this program are to assist cities and counties with assessing their existing environments; implementing changes in local environmental and policy infrastructure; and adopting priority public health practices to reduce risk factors for cardiovascular disease, stroke, and other chronic diseases. This program funds 10 communities which are assessed annually on eight priority community-based policy, systems, and environmental change indicators: physical activity, healthy food access, healthy worksites, environmental health, health care quality and access, healthy aging, mental health, and emergency preparedness. Results promote public health interventions proven to reduce risk factors for chronic diseases. Participating communities receive recognition awards based on their overall assessment score.

Rape Response and Prevention

The goals of this program are to reduce contact sexual violence by providing direct victim services to survivors of sexual violence, build capacity of sexual assault programs to serve victims of sexual violence and engage their communities in sexual assault prevention efforts through technical assistance and training, and conduct prevention activities. This program is funded by the sex offense mandatory set-aside allocation, which is provided to the OAG through an interagency subcontract. This program provides the following direct victim services to survivors of sexual assault: assistance with crime victim compensation; assistance with the Statewide Automated Victim Notification Service (if in an applicable county); information and referral; crisis intervention; advocacy; accompaniment to hospitals, law enforcement offices, prosecutors’ offices, and courts; and counseling. These funds continue to support sexual assault programs to implement strategies and activities specifically for the prevention of sexual violence using any of the following approved activities and strategies: educational seminars, training programs for professionals, developing and distributing informational materials, community mobilization, coalition building, and policy education and social norms change. Additionally, the OAG has partnered with the Texas Association Against Sexual Assault (TAASA) to provide technical assistance and training to sexual assault programs that are implementing primary prevention strategies, to increase access to individual counseling and therapeutic groups for victims of sexual violence, and to develop and support best practices for serving victims of sexual assault throughout Texas.